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Hi everyone, I’m Dr Brad McIntosh from Sydney Sports & Orthopaedic Physiotherapy (www.ssop.com.au). My specialisation is in running biomechanics and injury, and I'm looking forward to offering you helpful advice as you prepare for this year’s Blackmores Sydney Running Festival!
Hi Brad,I have been diagnosed with Hamstring origin tendinopathy.(45yr old woman, only running 12mths-fairly common i'm told). I've had a cortisone injection in it 1 week ago and am wearing a groin strap when running(seems to help especially up hills). Could you recommend any strengthening exercises or anything else to help.Thank you.
Hi Karen,Sorry I couldn't "Reply to your comment", so putting my note in here instead...hope you find it ok.High hamstring tendinopathy is certainly not uncommon, and is an injury you'll have to be patient with. Be confident, however, that when you feel some tightness or discomfort that you aren't doing any damage. Keep training consistently, and if you can regulate your terrain (i.e. flatter is better) that would be helpful. You can also shorten your running stride a little bit to unload the hamstring. Best if you avoid speed-work too.You need to strengthen the hamstring tendon with an eccentric-based training program. A physio can guide you on this, as the exercises we choose are based on your core strength and pelvic control. It is also often helpful to address any asymmetry in your pelvis, and your physio can assist with this also.Most importantly, be patient! These injuries are usually a nuisance rather than a 'show-stopper', and they do get better with appropriate exercise (eventually). Hang in there, and keep training as long as it is at a mostly-comfortable level.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad, I recently started running training again, and at some point a couple of weeks ago my left quad started hurting. I stretched it out, and then it was fine. However since then, every time I go running it starts to hurt again, and then the next day after running it's really tight and sore when I walk, especially up stairs. Now, my right hamstring is doing the same thing, only not as bad. Someone suggested the right is overcompensating for the left, as my body automatically tries to avoid using the sore muscles. Is this correct and is there anything you suggest I do? Thanks!
Hi Lou, what you're describing is a common problem when getting back into running after a break, and I think there is something to the compensation argument. We often see sore muscles and joints lead to other sore muscles and joints! Try these simple strategies, and if your legs continue to trouble you, have a chat to your local physio - you might need to give some attention to your running style, your pelvis and your core muscles:1) warm-up by walking for 5 minutes and then gradually ease into your run.2) gently stretch 'after' your run, not 'before'. There's some evidence that this may be a better strategy for injury minimisation.3) keep your runs flat to begin with. This will decrease the loads through your quad and hamstring. You've still got a good chunk of time before the event, so you can afford to build your base with some flat running at the moment.4) deep-water running with a flotation belt gives you a way of exercising the same muscles as you do in land-based running without the overload. It's also an awesome workout!5) try a topical heat rub to the affected muscles before you run. This isn't nearly as good as a gentle warm-up, but might help a bit with the stiffness.6) most importantly...keep going! Even if you can only run a few minutes before you notice the quad or hamstring, this is better than no running at all. Use this as a base to build your training on.Good luck! Brad
Hi,I've been running for quite a while - 5-6km 2-3 times a week without any issues. Recently I decided to up the distances a little with a view to eventually running a marathon. However, every time I get up to the 15-16km mark I run into trouble with my knees (pardon the pun).While I'm running I get a soreness, predominantly on the outside of my knee, but sometimes on the inside leg too. The pain usually wears off after a couple of days. I recently got fitted for some trainers, rather than buying off the shelf, but they haven't improved things.Any ideas?Paul
Hi Paul,It sounds as though you have ITB Friction Syndrome, one of the most common running injuries and certainly the most common cause of outside knee pain. It comes on at about the same point each run, and you generally can't run through it as it gets VERY sore! The problem is biomechanical as the ITB 'flicks' over the outside of the knee and becomes irritated.The main problem is with your butt! Shoes and orthotics have been touted as a fix for ITB friction syndrome, but I'm not aware of any good research on this and think it's primarily anecdotal. The mainstay of treatment is gluteal strength/endurance training and correcting your running biomechanics. Running up to, but not beyond, the pain is important too, as they tend to come on sooner after you rest for a week or two. I like to treat ITBFS quite 'actively', maintaining a running program but perhaps temporarily decreasing the mileage. If you send me through an email (firstname.lastname@example.org) I'll fire you an article I wrote on ITB Friction with some more info. It's actually an enjoyable problem to treat in runners, as when you treat them well you can have some spectacular results. When left to its own devices, or treated poorly, it can tend to linger on and on...All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi,I have what I think is a bone spur on the top of my foot which hurts whenever I run (straightaway). What can I do ot get rid of it or manage it so I can run without pain.?
Hi Ros,The most likely scenario is a painful exostosis or 'bony bump' where the 1st metatarsal bone meets the medial cuneiform. You can try lacing the shoe more lightly, or trial a broader running shoe, however you need to correct your biomechanics to properly treat this problem. This might include calf stretches, changing your running mechanics and/or orthotics. Have a chat to your physio or sports podiatrist to help you with this.It's unlikely, but bone stress can also cause pain on the top of the foot in runners, so it might be best to head in and get it looked at.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hey,I suffer from left lower back pain in the big back muscle with intermittent parathesia over the left SIJ. Also a burning pain in my left quad. I run three times a week which seems to relieve the pain until the next day? Can I do.Thanks
Hi Anthony,This is a difficult one to say without assessment - it would require a thorough look at your hip/pelvis/lumbar spine (and overall) biomechanics. Paraesthesia/burning are suggestive of a neural (nerve) component/irritation in this region.As general advice, I would be looking at what postures/positions/activities you are doing daily. Is there anything there that may be lending to a left sided problem? For example sitting at your desk, crossing legs or twisted to one side. Address this first and evaluate anything you may be doing during the day which might be contributing.Secondly, is there anything about your running that you think might be contributing? Also look at the surface of the road that you are running on - is it always one side with a camber so that left side is relatively compressed etc. Make sure that you are varying your runs and see if this helps.Often we see low back/pelvic/hip issues in runners associated with an underlying reduction in core strength/stability, and it often ties with hip biomechanics. Gluteals and core musculature are regions which tend to be implicated in runners with this type of issue as these provide stability for this area - it may be that a strength programme may be required.Please let me know if you'd like any further advice - but it may be worthwhile having a proper assessment to help you determine these factors.All the best,Brad.(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
I have bursitis in my left heel and it has been there for about a year. Should I do special stretches before training? Should i have an insert in my shoe? What sort of shoes are best?
Hi Elizabeth,Retrocalcaneal bursitis is common in athletes and can be difficult to settle. Biomechanical factors, ankle/midfoot joint stiffness, and muscle tightness of muscles higher up e.g. calf can all contribute, as does the control of muscles around the foot/ankle and up higher. It may also coexist with Achilles tendinopathy.A dynamic warmup including calf musculature, which may involve eccentric control through the calf/Achilles tendon, for example heel lowers from a step, may be more effective than static stretches alone. It would be important that this were not painful, however.If your symptoms appear inflammatory - i.e. stiff and sore in the morning after a run for longer than half an hour, and particularly sore at night, then it is important to reduce the inflammation by a relative period of rest/ice/anti-inflammatories as indicated. Icing the area following a run may help e.g. ice wrapped in damp towel, every two hours after.As a general guide, wear a footwear that is comfortable and feels like it provides adequate support for your foot - as not all shoes will suit everyone. Feel free to read a blog I wrote earlier on our website www.ssop.com.au" target="_blank">www.ssop.com.au about selection of footwear. It may be worthwhile discussing this with your physio or podiatrist.I hope this helps guide your query,Brad (* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au" target="_blank">www.ssop.com.au)
Hi Brad,I occasionally get pain in my left knee when running. It generally comes on randomly (not every run) and i can usually run through the pain if im running under 10kms. If i rest my knee after wards its usually back to normal by the following day (or two). I have played netball for many years and am thinking this could have caused my problem. I am hoping to do my first half marathon in September but cant normally get past 14kms without the knee causing me too much pain. I have never strapped my knee but was wondering if this may be a good option, as well as maybe taking glucosamine supplements? Would love to know your thoughts.Cheers,Michelle
Hi Michelle,Tape can be an excellent means of facilitating the desired control and supporting knee structures via means of proprioceptive feedback. There are several taping methods which could be appropriate for your knee to achieve a desired effect. It sounds like potentially after a particular distance your body may be fatiguing which can make an underlying injury or biomechanical fault susceptible to increased stress. There are also newer tapes such as kinesiotape which can also be quite effective here. You would want to discuss with your local physio your problem so they may guide a taping strategy specific to your needs.There is some evidence for glucosamine supplements in preventing early joint degeneration - I am unsure if this is your problem, but if you are concerned, you would be best to discuss this with your local GP.All the best!Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi there,I've read a fair bit about the benefits of an ice bath after a long or high intensity run but have some questions about best practice:1) Should I do static stretching before or after taking a bath?2) If my pool is around 12 degrees, can I dip my calves in or sit on the steps? 3) Is there an optimal position (seated/standing/legs out flat)?ThanksSteve
Hi Steve,There is some evidence to suggest that contrast baths (alternating heat and cold) and ice baths may help recovery - due to the effects on reducing microinflammation in muscle and therefore incidence on DOMS, as well as the metabolic effect.I am not aware of any set protocol, and I would think this would depend on the length of your run etc. Some leading football (AFL) clubs will do a cycle of 3 sets of 2 min cold, 1 min hot, for 3 cycles. The depth of immersion should be targeting the major muscle groups worked during the exercise. Please take caution immersing past chest particularly if you have a heart or other condition.Evidence suggests that a dynamic warm up and cool down may be more effective than static stretching alone - unless you have particular area/injury that needs stretching. However, everybody has different collagen makeup and may respond to static stretches differently.Good luck!Brad
Hi,I get a strange but strong pain along the outside underneath area of my left foot. (around the midpoint aread along the foot). It is worst when I get up from sitting and will eventually dissipate after moving a bit. X-Rays show nothing and am wondering what might be causing it. I do feel generally more tight on that side of my body (ie left side), from my hips through to my calves so not sure if it's just a result of that or something else. hip... Thanks
Hi Kate,Sounds like you have an interesting problem. It's really hard to give a formal diagnosis without physically looking at your foot (and indeed your entire biomechanical lower limb chain).If you have been running more than usual it could be that you are starting with some peroneal tendinopathy as the insertion of the peroneal tendons is into the cuboid bone near the base of the 5th metatarsal head. Tendon problems often 'warm up' and pain settles with activity, so I would exclude this as a problem first.Worth a trip to your local physio to get a formal diagnosis, but I would recommend not pushing through the pain and ignoring it at this stage.Have a look at this post on our website about tendinosis, ssop.com.au/common_injuries/body_parts/muscles,_tendons,_ligaments/tendonitis/tab0010/menu010. Hopefully this will give you somewhere to start.Good luck with getting to the bottom of the problemBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Sorry about that ...That last link didn't come through rightTry this http://ssop.com.au follow the common injuries prompts, select body parts and then have a look at the muscles, tendons, ligaments section for tendinosisBrad
Hi,Often, but not all the time, when I have been kneeling or had my knees bent for a while, it hurts a lot to straighten them again. For example, when doing the 'chair' hold against a wall, my knees hurt a fair bit. I am 14 and do gymnastics, netball and I think this could be caused by hiking. When coming down hill it puts a lot of strain on my knees.Also, my hips get stiff when I have come out of the splits, and yesterday, when I was just stretching I think I nearly dislocated it!Please give me some advice! Thanks :)
Hi Taylor,The most likely diagnosis is patellofemoral pain syndrome (also called anterior knee pain syndrome). This is most easily described as the kneecap joints not tolerating the forces that you're putting through them. Things like downhills and downstairs are fairly high load activities for kneecaps. Usually, there are some key biomechanical or movement problems and one of the most common issues is with the hip joints. It is VERY VERY hard to dislocate a hip joint, but it sounds as though they are a part of your movement problem.We see this quite a bit in teenage girls, and it is manageable. The important thing to remember or understand, is that there is nothing structurally wrong with your knees. We just need to stretch a few things and strengthen a few others to enable you to move a bit differently. Taping the knees will also help a lot in the short term. It's also possible that your knee pain is actually coming from your hips. Again, we can see this occur sometimes in teenagers, but it is unlikely. I'd recommend you go and see a good physio or sports physician near you to get this diagnosed and managed. You sound active, which is great, so the sooner you get on top of things the better and the less likely you are to have to rest from your sports and activities.Let me know if you have any further questions - email@example.comAll the best,Brad
Any ideas for shin splints and recurring peroneal tendonitis.....I just want to be able to run and it seems 1 step forward and 5 steps backwards. Have orthotics after the peroneal issue = shin splints I have been resting and trying to do very small 100m runs on grass, stretching my calves....it is extremely frustrating as I just want to be able to jog 5k a week and complete in my first fun run.... Any suggestions would be greatly appreciated
Hi RachellShin splints can be a real problem for runners (as I'm sure you are aware).If you are still getting problems even with the orthotics in, it may be time to look at the whole lower limb biomechanics. Underactive core and gluteal muscles can potentially lead to overloading of the muscles of the lower leg resulting in shin pain.If you are doing a dynamic warm up (walking on heels/toes, heel drop off step walking etc..) and have tried to keep your runs short to avoid pain and are still having issues, I would recommend getting a physio to screen you to see if there is an underlying biomechanical cause. Some physios have video analysis software that can assess you dynamically (i.e. while you are running on a treadmill), that would be the gold standard assessment.Hope that helps a littleBrad (* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi, I have a sore inner elbow on my right arm. A friend says its golfers elbow. I was hoping you could let me know what I should do to help my elbow recover. The pain is only slight now but I have had it for about 3 months. Originally it was rather sore. Any advice would be welcome !Thank you.Cheers, Tim.
Hi TimI agree it does sound like golfers elbow (also known as medial epicondylalgia). It can be from a small tear in the common flexor tendon where it blends into the bone.Most tendon tears benefit from a combination of regular icing (for 20 mins) 3-4 times a day and eccentric strengthening.You can try a counterforce brace (a simple wraparound strap used in tennis elbow rehabilitation) but if it doesn't work fairly quickly I wouldn't persist using it.I would try these things first and then see how you go over the next few weeks.Hope this helpsBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,I was recently diagnosed (ultrasound) with subacromial bursa impingement syndrome in my left shoulder,caused by longterm repetitive injury by my former husband. (Domestic Violence) There is no evidence of calcification. It has been becoming extremely more painful over the last few months. My GP said physio. would be very helpful and told me not to lift my arm above my shoulder. I am hesitant to have physio as I'm sick of the pain that it causes me. Do I just grit my teeth and do it? And in your opinion, does it usually ease the symptoms?
Subacromial bursa impingement syndrome causes inflammation of the subacromial bursa, which yes, can be quite painful. In order to understand what's going on in your shoulder, I'll explain some of the anatomy. You may have heard of a group of muscles called 'the rotator cuff' muscles which provide the stability in your shoulder. Bones and ligaments form an arch over these muscles, creating 'the subacromial space. This space is then filled with the subacromial bursa, a sac of fluid designed to prevent friction of one structure on another. A common cause of subacromial bursa impingement syndrome is shoulder instability. This can occur due to repetitive overhead activities with poor control of your shoulder blade and arm. This results in the rotator cuff overworking and eventually becoming tired. Once this happens, the shoulder loses the good rhythm it requires to maintain the subacromial space, and the subacromial bursa, can then become squashed, leading to the pain that you're feeling.Initially, icing the shoulder can help to try and bring down some of the pain and inflammation. Avoiding pain provoking activities is also a good idea at this time. Once things have settled, physiotherapy can help restore the control the shoulder blade has lost. Stability is essential before moving onto strengthening and this can be achieved with a simple exercise program. Once this is achieved, you would progress onto strengthening and more functional exercises. So, getting on top of the shoulder blade control, with specific exercises shown by a physio, should help with your problem.I hope this helps!!Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
HI, MY RIGHT KNEE ARE SORE.I GO TO THE GYM TO BUILD UP THE STREGH.BUT AM AFRAID AM COUSING MORE DAMAGE.I LOVE RACING AND KEEPING FIT.EVERYTIME I SIT DOWN I CAN HEAR THE BONE MAKING NOISE.
Hi Shirley,It is obviously difficult to say exactly what is wrong with your knee without getting a full history and examining it. However, you say you are carrying out exercises to strengthen the knee but are they the correct exercises?Your knee is not only supported by the muscles in your thigh, but also relies heavily on the muscles in your butt, your glutes. Their strength and control are highly important in the control of the knee.Grinding of the knee is usually caused by mal-tracking of the knee cap over the lower part of the thigh bone as you bend your knee. This can be due to weakness in certain muscles and tightness in others. Generally, improving the strength and endurance of the stability muscles in your thigh and butt and loosening out the over-worked muscles will help your problem. If you shoot me through an email, I can send you on some exercises to get you started.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi, I have tennis elbow and have been trying exercises that have been prescribed by my Physio - stretches and gently lowering a weight - pulling it up with the other hand - lowering it again... I am also getting pain in the arm near my elbow after waking in the morning. It just doesn't seem to be getting any better - what am I doing wrong? Any tips to speed up the cure?
Hi Peter,Tennis elbow is a difficult problem to manage and can be recalcitrant. Eccentric exercises (the lowering exercise), bracing or taping, and consideration of the contribution of your neck and shoulder blade are the cornerstones of conservative management. Even when instituted well, things can be quite slow to improve, but rest assured that it will get better.There have recently been 2 studies on the positive effects of the addition of platelet rich plasma (prp) injections in people with tennis elbow that isn't responding to appropriate physiotherapy. If you feel you have done everything right, as advised by your physio, it might be worth having a chat to him or her about the addition of prp injections at this time. Go to: http://www.prpinjection.com.au for more information. Just remember that the prp isn't a cure all. It may help, but ultimately you need to keep doing the eccentric strengthening exercises to get the tendon back in good shape. Good luck, hang in there as it will get better, and let me know if I can assist further.Cheers,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
HiI am finding i have terrible pain in my R)buttock/hip area, the more i sit. I frequently exercise (daily) and have no pain on exercising, but if i sit at my desk, on the couch or in the care for any length of time i get this pain, i have tried swapping chairs at work but this hasn't helped. Any advice for me?
Hi Emily,As there are many problems that can create this scenario, and the advice is quite different for each, could you give me a ring on 9252 5770 so we can discuss in a bit more detail? You may have to leave your number if I'm in with a patient, however, I'll give you a ring back as quickly as possible.Many thanks,Brad
I recently fell off my bicycle and broke my wrist (Colles fracture). I needed to have a titanium plate put in my wrist by ortho surgeon. Could you please offer suggestions/resources for exercises to assist me to regain maximum movement and flexibility. With sincere Thanks to all who can assist, From Jo
Hi Jo,The most appropriate exercises would best be determined by a physio assessing you in person, and will depend on what stage you are at in your recovery, the exact type of fixation used, your age and general health.For a general reference, you can check:www.northdevonhealth.nhs.uk/.../...s_fracture.htmlThis is quite a good description of the general principles of rehabilitation of a Colles fracture. Let me know if I can help any further - firstname.lastname@example.orgKind regards,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Jo,Also, please note that the link below discusses exercises for non-operatively managed Colles fractures, but they are appropriate after open reduction internal fixation also.Cheers,Brad
Hi there,I've had trouble with my left leg and hip area for a few years and after xrays, my Chiropractor told me that my bottom vertebrae is partly fused to my tailbone as well as the vertebrae above. This has caused my hips to twist forward and down and I often feel pain around the area. I go to the Chiropractor and Bowen Therapist when I begin to have trouble, however I am in my first year of university and cannot afford to keep up the appointments. I've been advised of stretches I can do at home but whenever I ask about exercise, they tell me there is nothing I can do. Do you know of any exercises I can do at home to strengthen the area?
Hi Jessie,This is a little difficult to say specifically without assessment of your low back/pelvic/hip region.If you are experiencing short term benefit from manual (hands on treatment) then it would be a matter of working out why the effects of treatment were not being sustained. Potentially there could be a work/postural habit perpetuating the issue. Often there is an underlying weakness, which may be related to your core (inner unit of abdominal/pelvic musculature) and/or hip stability/strength.Though you do have a structural anomaly in terms of your fused vertebrae/sacrum, this does not necessarily need to be painful, and it would be worthwhile having a qualified health professional assess your movement and strength to see if this may be contributing to your symptoms.Exercises would need to be tailored for your function. For example if you run regularly you need good core stability and gluteal strength in order to support your low back for directional/compressive loading. Clinical Pilates is one means of achieving this type of control so that your low spine/sacrum (tailbone) are supported for movement.If you'd like further info please refer to our website which has details regarding the benefits of Pilates/core stability exercises. Please let me know if you'd like any further advice - but I do think it would be worthwhile consulting a phyiso prior to undertaking an exercise-based regime.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi,I sprained my ankle about 10 days ago. My foot was rolled inwards, there was mild bruising and some swelling over the ankle bone which I managed with strapping.I'm pretty sure it was only minor, I've been walking normally for the past 3-4 days, and the swelling is barely noticeable if its still there at all.But the bone is still tender to touch (I've had an xray which ruled out a fracture) and the ankle joint gets a bit stiff if I sit for too long. So I guess I want to know when I can think about running again? Are there any precautions I should take such as strapping when I do start up again? And are there any exercises I could do to help the recovery along a bit?Cheers,Matt
Hi MattWhat you are reporting is quite usual with lateral ligament strains. The tenderness over the bone is from the ligament pulling away from the fibrous periosteal covering of the bone. This should reduce given time, the periosteum is highly innervated so thats why it is so sore to touch.As the ligament heals by fibrosis (the laying down of scar tissue) and the scar matures the collagen fibres in the scar shorten leaving the joint feeling stiff. This can also last for a few more weeks yet.Keep moving, keep stretching the ligament and start cycling/swimming and light walking to keep up your fitness. Strapping may help you in the early stages when returning to impact exercise.Balance exercises are also commonly overlooked in the rehabilitation phase too, so start balancing on one leg whenever you get a second, or use a wobbleboard at the gym.Most ankle strains take 3 weeks to feel 100% if the strain was minor. I would start to think about a light jog over the weekend with your ankle taped and see how your ankle responds. If you are nervous or it doesn't continue to improve a physio assessment would be the next logical step.Good luck with itBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
thanks for the advice, and very quick response! I'll see how I goCheers
Hi,6 weeks ago I fracutred my Radial head on a out-stretched arm and also pulled muscles etc I was in a back-slab cast for a week and then I was put in just a sling for another 5weeks and current. Last time I went to the fracture clinic the doctor told me to do some exercises like just bending my arm etc and hold for 10seconds and that was 3 weeks ago, and there hasn't that much of an improvement. What else can I do to help straighten my arm and loosen the muscles etc??
Hi KarlaBy far the commonest complaint following radial head fractures is stiffness, so you are not alone in this. I am assuming you had a minimally displaced fracture with no broken off pieces (comminuted).You would benefit from seeing a physio to mobilise your joint as by this stage your fracture should have healed. They will show you techniques to recover more normal joint movement. Self massage and heat help the muscles to relax, but by far the best intervention is movement itself.Don't worry about strength just yet, that will come later, but do focus on regular daily movements, just like your doctor has prescribed. I would also recommend turning your hand palm up and down (pronation and supination) to increase this movement too.Good luck with itBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,Thanks for that info. I have been to a physio who gave some exercises to do, but the doctor didnt allow me to anything resistant so there wasn't alot i could do. I went back I to the gym to my cardio class about 2 - 3 weeks and the punching doesnt seem to bother it all, my forearm just goes red but i think that is just because i have used it for a few weeks.I have been doing the exercise still and also have been massaging it. The muscles are still very, very tight especially in the forearm and my bicep area, my arm isn’t 100% straight. What can I do to help straighten it and loosen the muscles, if i put my palm up facing my face the muscles on the left are the ones that are very tight and sometimes very sore aswell.
Hi KarlaSorry haven't replied...I missed your reply!!The best thing to stretch a tight elbow is LLLD stretching (low load long duration). Which means you have to take your arm into a straight position (as best as you can) put a slight weight in your hand and allow it to stretch for 5-10 minsIt will make you quite sore when you first move it after this but you will find that over time the range will return. The soreness and stiffness are quite usual though. It is not uncommon to be stiff for months yet.Hang in thereBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
I suffer from sore acchilles tendons. I run a number of times a week 4-8k [keeping to the flat to create less of a strain on my acchilles] and play soccer, there are only a couple of days a week when I don't either go running or have soccer/soccer training. I would really like to continue with both these forms of exercise. I ice my acchilles after soccer but would like to know if it is OK to do eccentric exercises when they are still a bit tender.
Hi Glenda,Achilles tendonopathies are common in runners, and benefit best from a sound assessment which will also include addressing your biomechanics to see if this may be contributing.It is difficult to advise specifically without assessment of both of your Achilles and discussing with you their pattern of soreness. Achilles tendon problems range from varying stages of inflammation and stage of tissue healing - so the appropriateness of eccentric exercises for your Achilles will depend on the likely process occurring in the tendon. A physiotherapist can help assist in this regard. If the Achilles are sore because of acute inflammation, the best management for this is to relative rest the tender area from activities causing the trauma. Stretches for the calf, heel inserts, orhotics and modifying your activity e.g. reducing your running or complete rest from running, may help offload tension from the painful Achilles area as a short term solution.As the inflammation subsides, then the tendons require targeted eccentric exercises (tendon lengthening during contraction) to assist in tendon tissue repair. As a general rule, this should not be painful in order to avoid reaggravation of the tissue - and there are ways to begin modified eccentric exercises early so as to not do too much too soon.Chronic tendon pathology may require slightly different management, but it is best to consult your local physio to help get you on the right track.Please refer to our website on tendon healing at ssop.com.au/.../menu09All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hello!.I recently fractured my left ankle - I am at week 7 now, I really need to get back to work, hopefully next week. I have been taking calcium powder, vit. c, fish oils, chondroiten, and glucosamine sulphate. I was fitted with a moon boot which is now off most of the time while I exercise, my physio has come down with the flu & I am on my own - I have a bit of a phoebia about applying 100% weight to date ........Pls adviseIngrid
Hi Ingrid!I'm sorry to hear that. Sounds like you are being very proactive in terms of your nutrition to boost your fracture healing along!I am not sure whether or not you have been told to fully weightbear so it is difficult for me to advise in this regard. Even simple ankle fractures can take at least 6-8 weeks to heal, which will influence how much weight you should be putting through your foot. Your ability to weightbear will therefore depend on:- your type of fracture e.g. simple, comminuted, location, size, complexity, joint involvement etc., plus your overall bone health- your pain levels- your strength, mobility and stability of the muscles, tendons, ligaments around the joint, plus functional balance/control/proprioception- overall fitness/strength- your activity demands - e.g. sitting at an office versus on your foot all day for workIf you are having trouble getting in touch with your physio then I would advise to ring your orthopaedic specialist and check how much you are allowed to safely weightbear in terms of your fracture, and get some general advice from him. If you are weightbearing as tolerated then it would be best to gradually increase your exercise tolerance on your ankle such as graded increase in work hours. It would be best to follow up with a physio as soon as possible or check with someone else in the clinic.Please let me know if you have any further concerns.Best wishes,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,I recently injured my shin when I slipped getting on the train (I didn't "mind the gap" haha). Anyway, I had an xray and all was fine but I still have a lump on my shin bone and on the muscle next to it (8wks latter). Also I get some pain in my shin and tightness in that calf when I run. Is there anything you could suggest?Thanks,Lara
Hi LaraThats an unfortunate injury!It sounds like you may have a subperiosteal haematoma (or in English! - a blood blister just underneath the outer layer of bone on the tibia). These get hard after a while (calicify). Sometimes the haematoma can spread into the nearby soft tissues. This may even show up on an xray now (but wouldn't have at the time of injury)The pain is from the muscles (which insert into the periostuem) pulling at the injury site and this can take quite a while to go. (6 months plus sometimes!!)Heat/Ice contrast baths might help a little and gentle massage around the margins (but not over the centre) of the injury could help too. Physios often ultrasound around the margins but only over the soft tissues, not the bone.If you are concerned, or the pain gets worse it's worth letting a physio have a look to exclude compartment syndrome (which is super painful...but thankfullly it doesn't sound like you have that)Give it some time. Hope that helpsBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad , my problem has been ongoing for approx two years had bilateral groin hernia repair done one year ago and it has never really felt better , still having pain in groin when running , climbing stairs or doing any resistance on machines at gym, am planning to do marathon in September but am struggling with pain and soreness, am still running just the next day it suffers alot, .Any suggestions please, Cheers
Hi Sandra,I am sorry to hear of your ongoing problem. It is somewhat difficult to advise without knowing your type and location of hernias in the past e.g. whether they have been direct or indirect, located in the inguinal or femoral canal. There may be predisposing variables as to why this has occurred.Your inguinal and femoral canal is significantly influenced by the fascia and muscular support of the structures surrounding them. This includes particularly your abdominal musculature - obliques, rectus abdominals and transversus abdominals which have particular actions on your inguinal ligament, as well as pelvic floor and hip musculature and fascia (connective tissue).For this reason, it is recommended to maximise your abdominal/pelvic/hip stability to minimise any excessive stress on your ligamentous structures. Exercises would need to be tailored to your specific needs and take into account your biomechanics of this region. It is unclear whether the soreness you are experiencing is secondary to your hernia, or may be related to an underlying weakness or muscle imbalance. What you are describing in terms of soreness with exertion i.e. increasing intra-abdominal pressure can be typical of a herniated site. Potentially improving the recruitment of abdominal musculature may assist in some of the symptoms you are experiencing.It would be best to follow this up with a physio who may set you on the right path.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad..I wake with terribly sore heals and for the 1st few minutes of the day struggle to walk.. I'm trainnig for the half marathon and my 1st km is painful but then it seems to ease.. I have been and got orthodics, but find that I can't run in these, my feet seem to cramp, so I wear them during the day in my work shoes.. What else can I do to fix this painful problem.. Thanks Jeni
Hi Jeni,There are several structures that can create soreness of your heel region.From what you are describing it sounds like you may be experiencing pain as a result of plantar fasciitis, which is fascia at the arch of your foot; a problem common to runners. This can occur if the fascia is continually overloaded. This may be due to several variables including muscle imbalance/weakness/tightness around your foot/leg or ankle, overpronation and innapropriate footwear and/or training. Neural tissue can also either be a source or contributing factor towards pain at this site.Commonly it can occur with tightness of your calf/Achilles region, or ankle joint (subtalar joint) stiffness. A physio may be able to assist with manual treatment/massage of your plantar fascia, calf and mobilisation of these joints.It would be then important to address any underlying biomechanics - if you are cramping with your orthotics, potentially your intrinsic foot musculature works harder in these, or you are getting too much tension on your fascia prior to toe-off. Try a good dynamic warm up for your calves e.g. heel drop off step, self massage through calf and plantar fascia (though not if it creates more soreness), and an initial reduction in running intensity towards gradually rebuilding your distance at which you can run without worsening soreness.Otherwise, may pay to see a physio to check if there is any imbalance that some strengthening exercises may assist in improving - e.g. the muscles that support the arch of your foot.For further information, please see ssop.com.au/.../menu09Best wishes,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,I just finished my first half marathon on the gold coast in 1hr 53minutes. I have a couple of injuries, but am so excited that I did it I now want to do Sydney. I was diagnosed with patellofemoral joint pain syndrome due to a weakness in my glut. I had a cortizone injection that allowed me to go pain free and its not back yet. I have strengthening exercises and will get back into them soon. Is this syndrome likely to come back when I kick off my training again? Or can I possible gain enough strength it will disappear. I am also having a CT scan tomorrow on my foot for a possible stress fracture. I managed to run with minimal pain until around 13kms then I just pushed through. Is it normally around 4 weeks off with a stress fracture? I am just hoping I have not got one and can train for Sydney.Thanks Emma
Hi Emma,Congratulations on your first half marathon completion.It is very important you resume your gluteal strength exercises as soon as possible in order to build good support for your knee and ankle/foot, if this has been a problem in the past. The likelihood of this problem returning once you resume training depends on how well you have developed your gluteal control/strength with your exercise regime, and you would want to consider initial reduction of your load i.e. distance and the pace of your runs within comfortable limits for your patellofemoral joint.As a general rule, stress fractures will take around 6 weeks to heal and need relative rest from activity. It is very important that prior to resuming increasing load through your foot that any biomechanical reason for possible increased load at that part of the foot is addressed. With some fractures e.g. navicular this healing time can be longer due to poor vascularity. Depending on the fracture type and location e.g. if a tendon has been continuously pulling at the fracture site, then timeframes for getting back to sport can be longer.I wish you all the best - it sounds like it would be worthwhile following up with your physio asap and bring the scans with you so that they may set you back on the right track and advise further in this regard. There are exercises you can do whilst the fracture is healing (if it is a fracture) to maximise your cardiovascular fitness and overall strength to minimise length of time from your sport.Good luck,Brad
(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Bradi have had a few difficult problems to deal with, 1984 severe head injuries due to a drunk driver, result right sided hemiplegia. After years of physio etc i have regained fair bit of use however there were still noticeable signs of the hemiplegia. I have and i continue to ride horses which is hard but helps. 2004 i was diagnosed brain tumor under the cerebellum near spinal cord brain stem it grew from 4cms to 8 cms. 2007 it was surgical removed which did have an effect on the hemiplegia. The audio canel was also removed as the tumor got in there. Consequently i have serious balance problem which are control by medications. However i thankfully recovered to a degree. A secondary has been found but todate has done nothing much but they are monitoring as they feel this cannot be removed due to risks. I have started riding horses again, really against doctors advise but it helps and life continues. Recently i noticed my left side has compensated for the right side to a degree. if i move toes or something on the left the right side toes move however when i try to move right side there nothing, with that in mind the left side does and is compensating all the time for the right side. When i ride now the left side in the hip and groin struggles with the action of sitting across a horse. there has never been injury to the left side. I get serious pain in the groin/ upper inner thigh area which pulsates through the thigh to the hamstring area when first mounting a horse. Stretching before and after helps, walking sideways and swinging the left leg in circles to the rear and down help but do not completely solve it. i do inner thigh strectches as well. i take everything from fish oil to glucomine etc. Any suggestion on excerise to prevent or improve the continue pain in the groin thigh area. I have been told many times to cease riding horses for obvious reason i do not wish to i have also return to work and continue work in a physical job. Odds were at the time i was not going to survive i did i have always taken varying natural medications as well and believe this contribute to my position today.Col
Hi Col,I am sorry to hear of your difficulties in the past.It sounds like you may benefit from a review by your GP or neurological physio if you are noticing a recent change in terms of your function. If it is only recently that you are having more difficulty with your right side then this would benefit from assessment. Potentially targeted exercises for balance/coordination, right-side awareness ('hemineglect') and overall strength/mobility, as advised by a neurological physiotherapist, may be the underlying solution.It is difficult to suggest for your hip without thorough assessment - and the throbbing is an unusual description which too may benefit from a quick check at the GP. If the left side is compensating for the right, then I would consider addressing a few things:1. your overall technique for riding, setup of the saddle etc. - is there something that could be changed to assist your specific areas of strengths?2. modifying/monitoring your overall length of time on the horse, breaks etc.3. strengthening the muscles around the left hip to help promote good stability.It may be that you are relying heavily on your hamstrings/hip flexors/adductors, which could indicate technique issues, or imbalance of strength for example insufficient gluteal strength. Try putting your weight through your heels on the horse and pushing up using your bottom, or changing your trunk lean. Supported squats, sit-stands from a chair etc. could be exercises to help here. Assessment from a musculoskeletal or neuro physio may also help suggest specific exercises.All the best with your riding!Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Bradi get pains on the outside of my knees when i run long distances of over say 20km. When i put a support on it is ok. Is it safe to keep running with a support as i plan on doing quite a few marathons. Is there any stretches or techniques i can use to help me here.cheersGavin
Hi Gavin,It sounds like you may be experiencing iliotibial band friction syndrome - a problem common to runners. This can occur due to excessive friction of the iliotibial band over the lateral epicondyle of the femur, and or excessive compressive forces of the iliotibial band over the bursa on the outer part of the knee.This tends to occur when there is excessive contraction through this structure or improper biomechanics lending to overuse at this area. Often other factors e.g. road surface or training errors contribute.Support such as taping may assist in reducing the load at the outer part of the knee, however without addressing the biomechanics contributing to this, potentially this problem may reoccur.It would be worthwhile discussing with your local physio some exercises for your gluteal control/strength because frequently this is an area of weakness needing a targeted programme.For further information on this please refer to our website article at ssop.com.au/.../menu08.Good luck!Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Bradi did the sydney half marathon a while ago and am training for the Blackmoresi notice when I get to the 15-16km mark i get very sore around the hips and buttocksso much that I have to stop.what can I do in training to overcome this ?thanks in advance
Hi Berlin,This sounds like a difficult issue for you. Try changing your run so that you can may to increase your total distance. For example reduce your pace, run on the flat or a less difficult course. If you have reduced your running intensity and are still experiencing this problem, try walking for part or the remainder of the distance you are trying to achieve. Or walk:jog intervals.Without knowing the rest of your running programme it is difficult to advise further, however having a rest day or reducing the length of the run prior to your 16km run may help.Otherwise I would have a running assessment with a physio to ascertain why you may be experiencing targeted soreness in these areas.Best wishes,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,I recently had issues with shin splints (for the very first time) and had to pull out of the Gold Coast Half Marathon. Am a little nervous about restarting my training too early or doing too much but at the same time, don't want to miss any more runs that I'm signed up for. Just wondering if you have any suggestions for continuing to train but without aggravating the issue?ThanksNicole
Hi Nicole,I'm sorry to hear you had to pull out of the Gold Coast Half Marathon. You're right to approach your training differently for your next event so as to prevent the problem coming on again. Shin splints are common and can be a real problem for runners. They may involve different structures including the muscles at the front of the shin (particularly tibialis anterior), where tibialis anterior attaches to the bone (periosteum), as well as the connective tissue (fascia) which holds the anterior shin muscle compartment.
Commonly acute overload e.g. changing training too much/too soon or increasing pace too soon, can result in overuse in these structures at the front of the shin - which may be more susceptible to stress depending on your biomechanics.
As general advice, I would suggest trying a dynamic warmup which includes exercises for tibilialis anterior (front of shin muscle) and calf muscles. Examples include toe-walking, heel-walking, lunge-walking, heel-drop off step - the idea being to suitably warm up each area of your body involved in the types of motion required for running.
Secondly, trial a short run initially, keeping within a distance with which you feel comfortable. Then try to maintain this over a week. If you plan the number of weeks until your next event with the idea of gradually rebuilding your distance/pace, you will be less likely to fatigue/overuse these areas.
Often the lower leg can experience increased stress due to other areas of weakness up the body e.g. core/glutes and other tight areas. If you still feel you are not progressing it may be worthwhile having a physio assessment to screen these areas and perhaps suggest strength/stability exercises as appropriate and also to release any tightness.I hope this helps!Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi BradI am running the Blackmores Marathon in September (this being my first time, although I have completed 4 halfs in the last 5 years). I have been following the programme set fairly religiously for a 4 hour finish mark, however I am starting to feel achey at this stage. I have been having problems with tight calves a lot and have been trying to stretch them as much as possible. I am also starting to panic a little bit about my left knee. I had a replacement ACL at the age of 14, the operation involved graphs being taken my front tendon to replace the ACL. I have just taken up netball again and since playing on Wednesday my knee has been throbing .I don't know whether this is a reaction for not playing netball for a few years as my body is re-adjusting to the sprung floors and the twisting type movements involved. As some background information, I haven't really had many problems with my knee since the operation but i'm experiencing sharp pains inside the knee, this morning after my 16 k run last night it feels sore to touch around the front of the knee cap and to the right hand side. I would just like your general advice on the matter as for the next 6 weeks the training programme is getting more intense.Thanks, Leah
Hi Leah,The aggravation in the knee can be a number of things, but there are two likely scenarios in this case:1) because you had a patellar tendon graft for your reconstructed ACL, your chances of developing some anterior knee pain are increased, even this far down the track. Check out:ssop.com.au/.../menu08for some more information on this condition.2) given that you've had a pretty good run with the knee and it was flared up by netball, rather than running, it is always possible that you have an area of 'weak' cartilage in the knee from the original injury. This is very common. Not a bad scenario if this is the case, just give it a chance to settle down with some short-term rest and ice, strap it up and get back out there as soon as it feels ready. Oh, and maybe think about giving the netball a miss if the marathon is a higher priority?!If the knee swells and continues to be sore after activity, it could be worth getting it looked at to determine if there is some 'wear and tear' as a result of the initial injury. The only reason I mention this, is that it may guide your future running plans a little. We know that doing a lot of running kilometres on a knee that has had an injury such as an ACL rupture, can lead to early osteoarthritis (I say this not to worry you at all(!) but just so you can keep it in the back of your mind).If you're in Sydney, pop in and see me and we can work it up and set you on the right path.All the best,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
I,ve just started running again after almost 10 month break. After the run I,m expreriencing pain in my left hip.
Hi Tracey,Glad you've started running again! It's not uncommon to get some pains and niggles when starting up after a reasonable break, but could you give me some more information on your hip pain? For example, describe where it hurts, how much pain you have and during what activities/movements, what you do to make it feel better, if you've ever had any problems there before, roughly how old you are and what your running goals are.Look forward to checking in on your next post...Cheers,Brad
Hi Brad,I was just reading an earlier post on ITBFS. I too have very bad pain on the outside of my knee. I completed the Gold Coast half marathon with no problem. Three days later did a 14km run and couldn't walk down hill. Now it seems when I do go for a run at about the 3km mark I get excruciating pain in my knee both inside and outside. I ran 11km yesterday and could run through the pain on the flat, but as soon as I went up hill or down hill I had to bite my lip - ouch.I am so disappointed with my injury, as I feel fitter than ever. Do you think that I would be able run a half marathon in August and one in September or is that aiming too high? Would love to receive your article on ITBFS. email@example.comThank you
Hi Alison,It sounds like you may benefit from assessment of your knee - though it does sound similar to ITBFS in some of your description, it may be worthwhile checking other structures of your knee to rule them out as sources of your pain. Your description of pain "inside" the knee sounds like potentially a deeper structure e.g. in the lateral tibiofemoral joint compartment, may have been aggravated by the half marathon, and management may be different accordingly.It may be that some manual treatment of structures around the knee, taping and further advice, following a thorough physio assessment, may help sort this injury out quicker.I would be more than happy to send through the article - I hope it assists, and if you have any further questions please let me know.Best wishes,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,I just did an 11km running event and about halfway a muscle near my groin started getting a a little sore and my pace slowed. At the end of the run I couldn't walk upright because of the soreness/tightness. This persisted for the rest of the day. For the next two days the front of my thights were extremely sore and I wasn't able to walk downstairs or get up off a chair. Also of note is that I had my gallbladder removed last December and I feel as though I haven't regained the core strength that I had before that operation.I'm hoping to do the City2Surf (I completed this last year) & the 1/2 marathon in September (I had to pull out of this event last year because of persistent problems with my gallbladder - so really hoping I can do it this year!).Thanks,Bronwyn
Hi BronwynSorry for the late reply!! Sometimes following abdominal surgery the deep muscles can loose a little motor memory, forgetting the job they are designed to do. This can result in you compensating and overloading other structures, which then break down with increasing training.Just restarting running is sometimes not enough to remind the deep muscles how to function and you may need to see a physio and learn how to cue your deep muscles in order to 'jog' the muscle's memory.That being said you were only sore for 3 days after the run, which may mean you were suffering severe DOMS (delayed onset muscle soreness). This is a normal response to a change in muscle loading and although you had a bad episode this time, your next run should be less sore.It may be worthwhile you learning how to cue your deep muscles AND phasing up your distance/speed a little more slowly in future. But if you pull up terribly after your next run I would get yourself properly checked out before committing to more running.Let me know how you goBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi BradI have problems with my knee for years now (I am 35 yrs old). Physio didn't really help although I still do the strengthening exercises. Glucosamine & chrodroitin tablets helped for a while, but now they seem to be less effective. I have been to a doctor about it. She took a blood test for an inflammatory protein (?CRP) which was high on the first test but normal on the second test, and that seemed to be it as far as the doctor was concerned. But my knee is getting worse, I don't know what my next step should be. Any suggestions would be gratefully appreciated. I stoppped running a long time ago and have recently given up hiking as it's too painful to be fun anymore :(.
Hi L,It is difficult to say without assessment of your knee and you may need to give me a little bit more information as to your knee problem i.e. where the pain is, what activities hurt, what activities ease your symptoms etc. It's hard to advise without knowing what structures are involved and your biomechanics.Feel free to send through some of these details - I would be more than happy to try to offer some more suggestions.Kind Regards,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi BradJust wondering what minimum stretches you would recommend before a run - I do runs generally beetween 5km-10km. I am also doing the city to surf this year. I have a sciatic nerve issue on the right hand side which results in lower back pain and pain in my thigh just above the knee. Thanks in advance!
Hi Alice,It is best to start with a dynamic warmup involving all your leg muscles prior to the run. This could include a light jog then dynamic exercises such as lunge-walking, heel kicks, heel drop-off steps etc. For further information please refer to our website at http://ssop.com.au/ which has a recent blog discussing this.Then, depending on your areas of tightness it may pay to do a series of static stretches of major muscle groups e.g. gluteals, hamstrings, hip flexors/quadriceps and calf muscles. As you become familiar with this as a routine you will begin to notice which areas tend to get more tight with your running.If you have sciatic nerve problem on right side you will need to be particularly careful with hamstring and gluteal stretches to maintain a normal low back curve - best performed laying on your back to stabilise your spine - and not do the stretch into any discomfort. The location of your sciatic nerve irritation will determine the stretches/exercises with which you will need to exercise caution.Good luck,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi BradOnly weeks out from the running festival, in which I will be running the half marathon. I have a minor tear in the calf. Can you recomend any activities, to keep me in shape for my run, that wont be a burden on the injury.Kevin
Hi Kevin,I'm sorry to hear of your recent injury. There are specific exercises for calf tears that you should commence as early as possible in order to strengthen the calf muscle and assist good repair through the torn area. Chat to your local physio and they may be able to advise what level of calf strength in the form of theraband, raises etc. are most appropriate depending on the size and location of your tear.For cardiovascular fitness you may be able to try cycling or swimming (low impact) at a higher intensity. If you have access to a pool you could also try water jogging at a depth that is comfortable for the calf, and progressively move to more shallow depths. Make sure you are not feeling any tightening/cramping through the injured area or surrounding calf.Ensure that you progress your calf exercises to include exercises for power (increased speed) as well as endurance - as it is important that the muscle acheives this to minimise any chance of reinjury.All the best with your rehabilitation,Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
sorry lol post got hit a few too many times
Hi!!I am 28 year old female and started running about 1.5 years ago. First 6 months went great and then just before Sydney Bridge run my left leg became really sore. It had a specific spot on the bone that was always quite sore, but would kind of go away during running but the next morning I would be limbing until next training session when I just" ran it off". I ran the 9km Bridge run under 45min which was a great time for me but after that the leg became so sore that I couldn't put any weight on it in the mornings.Doctor said it was a stress fracture and so I stopped training for a while. I started again in Jan this year and started of great but kept having sore claf muscles or just achy legs all the time and now I think I have another stress fracture forming. I don't train that hard and even if I don't train my bones seems to be always achy and tired.Is this old age creeping in or am I lacking a nutrient or something?It is slowing my training down because i have to stop every month or two.Thanks!
Hi TaijaOvertraining is only one reason for developing stress reactions. There are also medical reasons as to why someone may be prone to stress fractures. For example polycystic ovarian syndrome, osteoporosis and long term prednisolone use can predispose people to stress fractures too.You are 28 (therefore definately NOT old!) and so you shouldn't be feeling old. I think your best strategy is to be systematic. Firstly correct any biomechanical factors that may predispose you to stress reactions (such as weak core or gluteal muscles or tight calf muscles for example). To do this you should go see a physio who can look at your running style and test to see where you should start.Secondly a referral to a good sports medicine doctor (your GP should be able to do this for you) to check there is not a medical reason for your problems, and also to confirm with a bone scan as to whether this is indeed a bony injury.Lastly when you are sure your are medically and biomechanically sound, then gradually increase your training load.I hope this helps you.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad, I strained my hamstring (thigh) last night during speed training. I've been pushing pretty hard for the last few runs and I guess I did not do enough stretching (totally my own fault ). The annoying thing is i was running really well, good form and controlled, but felt tight in my calves warming up and then on the second sprint felt like something was about to pull. I stopped straight away. I can walk on it so it's not a severe strain. What should I do about training?? I'm not running for the next 3 days for sure but I really need to train at the weekend. Im doing my first half marathon and can not afford to slack off on training now but i don't want to make things worse. Any suggestions?
Hi MarianneThe most important thing right now is to settle the acute reaction. You are wise to rest for 3 days and ice and possibly look at compression also (skins etc work well, especially the long leg ones).Light walking within painfree range should maintain the contractle tissue nicely over this time. Gradually extending the stride lengths over the next few days BUT stay inside your pain threshold.You are better to err on the side of caution with regard to resuming training. It is fine to go into a race a little underdone (the glory of the adrenal response should pump a few seconds off your time anyway!! - especially if your lead up work has been good). But to push to hard too soon is risky as restraining is very common in the early rehab period.Listen to your body with regards to returning to training. Gradually increase your walking until you are at a jog, then carefully start striding out. Light dynamic hamstring stretches should be started at day 5, and hamstring strengthening can start in earnest from day 10 (focus on eccentric training like painfree small range Nordic hamstring curls/Romanian deadlifts and then progress over time).It will be ok if you DONT push it too fast. Be patient.I hope this helps you.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi, I have recently kept up running after having completing C2S. I have recently been getting pain in the front of my left knee. The pain is now so intense that just walking hurts. I have stopped training and don't feel like its getting any better.
Hi TrishThe reason for your pain could be one of many things. It helps to have more information for me to give you better advice. You would definitely benefit from being reviewed by a good physio so that they can figure out the cause of your problem and advise you accordingly. If rest alone isn't working it is worthwhile getting it checked out.If there is point tenderness at the base of the kneecap it could be that there is some patellar tendinopathy, if it's more vague it could be a kneecap tracking problem. Call me at the clinic or email me directly and I'll see if i can help figure it out.Sorry can't help more than that at the moment.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,Any tips for the treatment of what I believe is "metatarsalgia". Its in the joint of my second toe (next to big toe) right on the ball of my foot. I havent changed anything about my running eg same orthotics, same shoes etc. It starts to get painful after about 7-8km in to a run. When I run 10-12km + I have to stop, take my shoe off and massage the joint just to get me through the next couple of km's before doing it again. Very frustrating !! I have entered the Half and want to enjoy it!!
Hi Brad,I had a nueroma between middle and 4th joints in my toes, nasty pain like standing on a nail. I fixed it with a ten dollar silicon toe spreader from the chemist. A big thick one like a dumbell in shape. It spread the toes and the joint and took the pressure off! Wow what a difference. I use it in my running shoes... Not sure if yours is the same but I had to just say this as mine was so easy to fix!
I meant: Hi James,Sue.
Hi JamesIt does sound a little like metatarsalgia I agree, but if you have high arches and a short big toe it could be a number of other issues too (like a stress fracture or a mortons neuroma!)You can trial a metatarsal dome in your orthotic (if it doesn't already have one!) speak to your podiatrist who may review your orthotics (especially if they are a little aged!)It is a common problem with runners and can sideline you if you keep pushing hard. Ice and activity modification would be a good start (and making sure the cushioning system is still working in your runners).A physio may be able to video your running style in case there is a biomechanical reason for your 2nd toe to be overloaded. Then you can correct the cause.No magic bullet unfortunately. Let me know how you go.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi BradI recently ran the C2S, and am now due to run my first Blackmores half marathon. I went for a 15-16km run on the weekend. Towards the end of the run my left Achilles was getting quite sore, although I just attributed it to the back of my shoe pressing inot it, as I've never had any problems with this area before. However, since then, my Achilles has still been sore when I walk (regardless of the type of shoe I'm wearing), particularly going up stairs, stretching on to my toes etc, although it is no longer as painful as it was immediately after the run. Is it just a case of resting the Achilles as much as possible (e.g. no running, lunges or squats) until it feels ok again or are there some stretching/strengthening exercises that I could do? I should also add that during my last run, my right knee was hurting a bit and so I was running a little bit awkwardly to compensate for that - could that have had an impact on my Achilles?Thank you!Sarah
Hi SarahThe Achilles tendon in commonly injured if there are biomechanical faults with your running style. It's always worthwhile having your running assessed so that you can be viewed dynamically as well as having a 'static' assessment. A heel raise often helps in the early stages (or high heels) as this reduces the preload on the tendon during walking.Ice and activity modification is also important so you are right to back off a little.Eccentric calf exercises are good to start as soon as the acute pain is over, and research shows that doing these exercises under load and into pain should gain you the best results.I hope this helps you.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,For a few weeks now after a big cleaning session at home, up and down, crouching, scrubbing etc., I developed pain in the "hip" area. Pain when I crouch to pick something up off the floor, and pain when standing, when I lift my leg up especially if it is rotated to the side a bit as I do this. Pain is there too when lying on side to sleep - especially on opposite side. . It is fine normally, and walking and general times, a small pain in the TFL/glut medius area... but it flares up about 1 1/2 hrs into a run, -- short runs are OK. I did 81km last week and only had trouble during the one 32km run! This week my 15km. last night flared it up... After, I can settle it down by the next day and run again! I use ice, glut strengthening- push against wall with opposite foot... rolling into muscles with a rolling pin... I'm not sure when to use, trigger point, stretch, strenghthen and rolling pin! I don't want to do the wrong one at the wrong time...With only 3 weeks to go what would you suggest to do so I don't have to put up with pain and maybe damage from km. 28 of the Marathon? (This is my 3rd. marathon, and first time this has been a problem.)Ta.Sue.
Hi SuePinching pain in the front of your hip/groin region can indicate a hip joint problem. If it's more uncomfortable laterally over your hip it is more likely to be a gluteal tendon problem.The treatment and management of both is quite different and so I don't want to advise you as to which way to handle this based upon only what you have told me so far.I would recommend definitely getting this looked at asap. If the physio has access to real time ultrasound they can scan the hip joint for internal swelling (effusion) of the hip joint quite easily and that can tell you if the joint is affected.The fact it settles quite quickly is a good thing, but I wouldn't want you to be releasing your hip muscles if you have a hip joint problem. I'm happy for you to email me directly (firstname.lastname@example.org) and I'll help where I can.Brad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,Since I ran the Sutherland to Surf (11km fun run in South Sydney) I have had a really sore achilles (on my right foot) that seems to make my ankle swell every time I run. The doctor told me just to rest it, but I dont want to stop running. Is there any serious issues that can cause this to happen? Or do I just need to be more specific when stretching? Also, when doing that fun run, about half way i got pins and needles in my right foot which then proceeded to make my foot and ankle numb. I loosened my shoe a bit but this didnt seem to make too much of a difference. I'm running in the 9km Blackmores Fun Run and would love to do it without any pain...hopefully! Thankyou so much for any advice you can give me!
Hi LaurenThere can be a serious problem called exertional compartment syndrome. When you run your muscles can increase in size by up to 20%. This can squeeze the blood vessels and nerves that run through your lower leg and can be a reason for the pain and numbness you feel.I would go see your GP and get a referral to see a sports medicine doctor who can test for this. You would be wise to keep your runs shorter in the interim as any activity that doesn't cause pain or numbness is fine to continue with.If your shorter runs are well tollerated gradually increase them over time, but if the problem continues to bother you definitely get it checked out.Let me know how you goBrad(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi brad,For the past 2 months I have had a sore right knee... The pain is at the back of my knee and extends to the inner side of the knee. It is only sore when i extend the knee and as soon as I start running and the muscles get warm, I cannot feel it... I am running the half next month and was wandering if I am doing the right thing and not causing more harm? Thank you! Kim
Hi Kim,Sounds like you may have a bit of tendonitis in one of your hamstrings. The hamstrings bend the knee backwards and are stretched by straightening the leg (as i'm sure you know from a hamstring stretch). The reason the pain reduces once you start running is because you 'flush' some of the inflammation out of the tendon sheath which helps to relieve the pressure and therefor reduces the pain. The main thing you need to ascertain is why is this happening? A lot of the time our hamstrings are over-active due to poor core strength, altered running posture whilst running or they could just be too tight. It wouldn't be a bad idea to get in and see either one of our physio's in the city or your regular physio to see what we can do to stop the pain coming on. You should ice the painful parts of the knee, start some gentle stretching of the hamstring and perhaps have you shoes/feet checked to see whether they are contributing to the pain at all.This is just one possiblity as to why you are getting pain in the back and outside of the knee, for a definitive answer (because without a physical examination of your leg it is hard to correctly diagnose the problem) it would be best to get checked out now so you have at least a few weeks to fix the problem and do the half with as little problems as possible.Hope that helps(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Hi Brad,Last Tuesday I was doing my morning training ( Hills day ) when I tore my left calf muscle..It felt like a stab in my calf but after one day putting ICE PACKS continuously the pain has reduced to 50% and today (Thursday) I barely feel it. How can I know if is just a sore muscle or a tear in the muscle ?..... there is any exercise you recommend ?....and lastly... WHEN can I go back to running ??... SRF is just in the corner...Could I be able to run my 9K's in 4 weeks ?...Cheers,JUAN
Hi Juan,This is a bit of a difficult question to answer without seeing you... Calf tears are notoriously bad when it comes to returning to sport and re-injry. We grade tears from 1 to 3, with 1 being only a slight tear that can have you back running within 10-14 days to a grade 3 tear which means that the muscle belly has torn all the way through which is more like 6-8 week recovery. Its good that the pain has settled quite quickly but a muscle tear is like a tear in a ribbon, once it is torn a little it is at risk of tearing further if you dont give it a chance to heal. That you describe a 'stab' in the calf, indicates to me that it is most probably a tear and you should have treatment on it as soon as you can to help with swelling reduction, scar healing and restoration of gait/running if you are to have any chance of getting back into running sooner rather than later. Sorry not to be more specific, but its really better to be safer than sorry with calf tears as if you dont get them seen to quickly and effectively, they can come back to bite you over and over again.Let me know if I can help any further(* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770 or visit www.ssop.com.au)
Do I have time to recover? Saw a Physio Friday, i have a very very tight Tensor Fascia on my right side. No major pain in other areas. Taking time off now till Wednesday from running. Stretching 3 times a day for my ITB area and hip flexors (foam roller and other stretches). I am in my 14th week of Marathon training. Did a half marathon in May, properly been training since February 2011. Will i have time to recover by September 18th? I was begging my tapering next week anyway, but this will be the longest i've gone without running. Any advice?
Hi Erika,Resting for a few days and continuing to release your TFL and other structures sounds like a good idea. However, there is obviously a reason as to why these structures became tight in the first place. How long have you been having trouble? Poor use of your glute muscles and a weak core are often the cause of TFL tightness. Generally, you manage ok for shorter distances but then muscle fatigue sets in and the incorrect muscles start to compensate resulting in discomfort for you.You still have 3 weeks to go before the run and it sounds like you have done the hard work required so far. Now that you have started to taper, it means you will have extra time to work on strengthening the correct muscles!!If accessible to you, real-time ultrasound imaging of your core muscles can check if they are working correctly and video analysis of your running style will allow you to identify any problems here. Adjusting any abnormalities found and carrying out a good core and glutes program for the next 3 weeks will definitely help you out on the day. Don't worry too much about straying from your training program a little for the next few weeks. It's ok to go into the race with a slightly more aggressive taper, as it sounds like your lead up work has been good. The most important thing is to not bring yourself undone with an injury this late in the game. I hope this helps, and best of luck putting it all together on the day! Brad( * this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
*begging = beginning
Hi Brad!I woke up one morning with an achy right ankle, but didn't think too much of it as it was my rest day from my marathon training. Unfortunately, the ache remained the next day. It started alike a "tight tendon" feeling at the central part of my ankle, but now it toggles between 9 o'clock position to 2 o'clock position. It flares up whenever it likes and this frustrates me as I can't run fast now. X-Ray shows no stress fracture. I'm still seeing a Chiro, but I'm desperate to get this 'fixed' for the Sept marathon! Please help!
Hi Jenny,That does sound difficult. Unfortunately it is hard for me to advise as I'm not quite sure of the location of your ache (central could be towards front, side or middle) and also a little unsure of the movement you are describing. As such it is difficult to know what structure is creating your discomfort.If you are experiencing an ankle issue, in order to address the joint mechanics, it is important to also look at the soft tissue structures around the foot/ankle (muscle, tendon, ligament). Looking at the strength, balance and overall function of these areas is vital in order to establish how your foot/ankle is behaving under loaded conditions e.g. running. It is also important to look at your overall biomechanics e.g. pelvis, hip, knee to assess whether this is contributing. An experienced physiotherapist may be able to assist in this regard, in addition to observing your running technique.As a general guide, try considering the surface you are running on (is it uneven ground versus hard ground versus a camber?) and establish whether this may be contributing. Try changing your load i.e. running shorter distance, reduced pace at a comfortable level, and gradually rebuilding. A trained professional may also be able to also examine your footwear and advise whether this is appropriate. There are taping techniques that could also assist you to enable you to continue running whilst offloading the injured structure (though without knowing, it is difficult to advise here). I hope this assists you - please let me know if any further queries or concerns.Brad( * this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
Hello, I'm 35 and picked up running this year and ran a half marathon in July. Two weeks later I tore my calf muscle doing an aerobics class. I am 4wks post-injury and can do calf raises, gentle calf stretches and I'm walking heaps. What else can I do to recover? I am very very keen to get back into running. Thank you!!
Hi Margaret,I'm sorry to hear of your injury.If you have strained your calf you will need to do targeted exercises for the strained muscle which will vary slightly depending on the size and location of your tear (best to chat through with your physio). The exercises will need to target your calf strength and eccentric control (an important part of muscle repair). Endurance is important and you should be aiming to do high repetitions of calf raises, or until the calf fatigues.As these exercises progress, you should begin to perform them with increased speed (plyometrics) in order to prepare the muscle for quicker activity.Best to consult with a physio as the individual nature of your injury will determine your ability to return to running. Guidance in the above areas will also be useful.All the best! Please refer to the information on our website at the address below for further advice regarding muscle injuries.Brad.ssop.com.au/common_injuries/body_parts/muscles,_tendons,_ligaments/muscle_strain/tab0010/menu010 * this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
Hi ya,I have just got back into my running & went for a 1/2 hr jog & then another 1/2 jog the next day, on the 2nd day I started getting a pain around my left hip area. Once I stopped the pain continued and is stronger once I get up after sitting for a while & with every left step the pain is increased. It feels like it might be around the muscle around the hip area, is quite annoying, now the 3rd day & I still have the pain. Thanks for your help.
Hi Samantha,This is again unfortunately a little difficult to advise without knowing the exact location of your pain around the hip (i.e. front/side, buttock), and there are quite a few muscles involved around your hip! If the hip joint itself has inflammation this can make your hip tight as well. Depending on the structure involved, and particularly whether there is inflammation of the hip will determine best management. For example, if there is hip joint inflammation then relative rest from weightbearing e.g. using crutch or stick, is indicated. However if you have strained a muscle then management will be significantly different.If you like you can send through more information i.e. where the pain is, how it behaves over a day e.g. worse in morning, type of pain, whether you have any noises in the hip, and what movements hurt it, and I can try to advise further. Otherwise, if it doesn't settle, it may pay to visit your local physiotherapist for more specific advice.Kindest Regards,Brad* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
Hi BradI am a very new runner (about 2 months) and am attempting the bridge run this year for the first time. I did the unity run about 2 weeks ago, which felt fine but later that night, I developed a pain in my right knee. Specifically, the pain felt like the muscle in the lower left hand part of my knee (ie the inside of my knee) was 'missing'. It took about a week before the pain went and I didn't run for 5 days. I iced/rested/elevated and supported it over that time. Yesterday I went for another run, where I had to turn around a few times while running for various interruptions and my knee has started hurting again, not badly but enough to make me limp slightly. Is it just a sprain or something worse? Thanks for your help!
Hi Angela,It is difficult to say without seeing your knee what structure may have been injured by your run.It sounds like your run may have stressed a structure of your knee, which has resulted in a patellofemoral joint problem. This could also be the primary problem, and is common to runners. The 'missing muscle' sounds like it is your VMO, which is the inner quadriceps muscle often inhibited in response to knee pain or swelling, particularly of the patellofemoral joint and its associated structures.This muscle needs specific retraining to ensure it regains appropriate control (timing compared to the outside quadriceps muscle) and strength, so that you do not experience further tracking issues of your patella (kneecap).An experienced physiotherapist will be able to assess your knee and advise further. Biofeedback may also be used to assess the efficiency of your quadricep muscles. Please see the link for further information on patellofemoral problems - however bear in mind this may only be part of the overall issue. Best to get it checked out because it is likely some exercises in the right areas will point you in the right direction (and assess any other contributing reasons as to why it may have occurred in the first place):ssop.com.au/.../menu08Good luck,Brad* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
thanks alot for your advice Brad.
Hi Brad, I am new to this forum but it looks great. I am having trouble for some time now with my Piriformis muscles...would you have any recommendations for me to help with this issue...just in the buttock mainly and maybe the odd time behind the knee.Thanks for your info. Trish
Hi TrishSorry for the late reply, we've been backed up since the running festival!The question you really want to ask is why is the piriformis working so hard? There is usually a weakness in the deep hip musculature that is resulting in piriformis being overloaded.You can stretch/massage/dry needle the muscle to relax it but that deals with only the symptoms, not the cause. You would be wise to get the mechanics of the hip checked to see if there are any specific strengthening or control exercises that will reduce the demand on piriformis.A good physio or sports physician assessment would be apropriate place to start.Hope this helpsBrad * this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au)
Hi Brad..Thanks for your info...re my Piriformis...no doubt should find the appropriate person on the Gold Coast where I reside.Cheers Trish.
Hi Trish Wherever you end up going, it's a good idea to check whether they can use RTUS (real time ultrasound) to assess your hip function. This has been pioneered by Dr Allison Grimaldi (physio) based in Brisbane. She might be a good person to start you off, or will have more local knowledge.Good luck with itBrad
Hi all, registrations for the Blackmores Sydney Running Festival are now open. To register go to www.sydneyrunningfestival.com.au and receive your free early bird singlet today. To connect with other runners competing in the race, go to our Sydney Blackmores Running Festival 2012 group. Brad, our physio will be back online soon so watch this space.
Hi BradI have sprained my left ankle twice this year so far (second time while it was still recovering from the first incident when I put my foot down a hole while running). It's now been about 2 months and I was only getting periodic 'twinges' so thought I'd at least be able to do decent walks again, however proved myself wrong last weekend. Any ideas on what I do can to strengthen the ankle? I usually walk or cycle as my main points of exercise, and haven't been able to do so since January and it's certainly not helping my weight loss! Too cold to swim now so not sure what to do - can you recommend something? Cheers, Carol
Hi Carol,It's a familiar story...sorry to hear it hasn't been settling well. There are a few strategies that you could employ to see if you can get going again, however, if the ankle continues to flare up it might be worth getting in to see a good Sports Physio to get an accurate diagnosis.You should definitely tape or brace the ankle for all exercise at the moment. The research suggests either strategy will help to prevent another sprain, and can help with managing post-sprain pain and swelling. I like bracing as it's quick, easy and effective.Secondly, after each exercise session, stick your foot and ankle in a bucket of cold water with ice for about 10-15 minutes.Choose exercise that is relatively un-weighted initially. Generally speaking, the ankle should tolerate the bike reasonably well, but start gently and build it up slowly. The goal at first is to get some movement and loading back into the ankle, rather than working up a sweat. As your ankle demonstrates that it can handle what you're throwing at it, then you can ramp up to get some cardio benefit. Once you're tolerating this well, try the walk again.Balance training is the other challenge you should give the ankle. Even if it's just standing on one foot and holding it for 30 secs throughout the day. If you need an added challenge, close your eyes (but be careful not to fall!). This works the proprioceptive system, so you're less likely to sprain it again.Good luck, and if you continue to have problems as you try to increase your exercise, get in to see someone to establish a diagnosis. Hope it starts to behave for you!Brad* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi. I have always suffered from excruciating migraines since my teens. Actually I get the worst kind cluster headaches. Would these be related to anything to do with me cracking my neck and shoulders. There is not one day that goes past that I dont crack my neck. I need that relief. Massage temporarily helps. Thank you:)
Hi ZoeIf you are having relief from cracking your neck and massage then your neck does need to be considered in the role of your headaches. If you are continually cracking your neck then these joints could be hypermobile (meaning have too much movement). I would suggest that you may benefit from some strengthening for the little muscles that support the neck, just like you may hear about core strengthening for low back pain. This will provide some support for the joints and ligaments in your neck and you may find you won't have to crack your neck so much. As the neck is considered by some as a "trigger" for cluster headaches and migraines, this may also have the effect of lessening the intensity and frequency of your headaches.Hope this helps* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi Brad,Can i please ask for advice on my calf muscle please? I injured myself last Saturday playing netball (centre position). I stopped playing quickly once a felt pain when trying to sprint in my lower calf. (Perhaps soleus?) I saw the physio on site who said to rest it til mid week and put ice on it. I have just been stretching it during the week. It has been OK to walk on. I tried to do a gentle jog yesterday and tried some calf raises. It is more sore today. I won't go back to any training until it is OK as I'm anxious not to injure it more.I had been increasing my running the previous month to 2 x 5-6km run a week,one cross training session and one netball game. (I'm 41 y.o. and have previously sprained the same ankle a few years ago).I'm hoping to do the 9km run (which I did last year). Any advice much appreciated!CheersAnnelise
Hi Annelise If indeed you have strained your calf muscle then it sounds like you may have just tried to get back into running a bit soon. It depends what grade muscle tear you have done but even the minor tears can take 2 -3 weeks with the larger tears taking up to six weeks and sometimes longer. Before you return to running you want to make sure the strength and range of motion is full and equal to your non injured side. Its good to hear that you have been doing some stretches and strengthening exercises but I think you probably want to be a bit more gradual and keep advancing the strengthening work for a bit longer before you head back running. OF course, due to the fast change of direction that happens in netball this will take a bit more time to return to and you want to make sure you are doing some sport specific exercises before you head back on court. Good luck* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi, I would like to ask about cramps in my hip and leg. I do yoga 3 times and walk (very fast pace) 4 days a week. On Mondays I walk only 6 km (the shorest distance for the week) but this walk is with very steep hills. On this night at yoga, I always get a cramp in my left hip and leg. The other yoga sessions I don't. Would this be due to the strong morning walk ? I always make sure I have water whilst walking and during the day.ThanksKathleen
Hi Kathleen I would say that the cramping is due to the fact that the walk is uphill when the others aren't. This requires the muscles to work harder. You tend to get cramp as the muscle fatigues and is struggling with the intensity of the exercise. I think you may benefit from conditioning your legs for the hill walk, have adequate carbohydrate and water, stretch those muscle groups before and after with a light warm up and warm down. Whilst you are working on conditioning those legs you may want to make your walk shorter duration or less intensity and gradually build back up again.* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi,I'd just like to ask a question since there is a lot of confusion about this. Does working out/lifting weights stunt growth?Thanks,PeterUniversity Student
Hi Peter - At this stage, we have no credible evidence to support the view that weight lifting can stunt growth. In fact, the american college of sports medicine takes a favourable view of weight lifting during adolescent years. Of course, we wouldn't recommend lifting heavy weights at and early age, or without knowledge of the correct technique and adequate supervision. If you are new to training I would definitely recommend working with a good personal trainer to get started.* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi Brad, I'm currently doing Pilates and Yoga, and some walking. A few months back I was diagnosed with gluteus medius tendiopathy (probably spelt it wrong..) and was then advised not to jog. I'm quite overweight (20 kg over) but I'm longing to run again. What are your thoughts? What kind of program would be good so that I can run the 4kms in September. I did actually do a fun run a few years back (5kms) but that is a while ago now I guess. Thanking you! Helene
Hi Helene,Tendinopathies are often difficult condition's to treat because as soon as you feel as though you are getting better and can do more, you try a run or some exercise and are put back a few weeks. The key is to find out the "cause" of the problem and very gradually return to activity over a period of time. The cause in the case of gluteus medius tendinopathy is usually related to poor pelvic, hip and/or core stability.The role of the gluteus medeus is to keep the pelvis parrallel to the ground as you take the opposite foot off, as in walking and running. If this doesn't happen, your hips start to swing side to side and up/down and you aggravate the tendon further by stretching the muscle and tendon unit every time you walk. This would obviously be amplified if you were carrying a little bit extra weight and even more so if you started to run. It becomes even more complicated when you are trying to lose weight because you obviously need to exercises to do so and if you want to run this will just set up a vicious cycle which can be hard to get out of without the correct advice. I'm not sure if you have a physio that can go through your Yoga/Pilates exercises with you because these classes are great if you are activating the correct muscles, but can promote incorrect muscle recruitment patterns if you are not. To make the 4km run you need to increase you cardiovascular fitness. This can't be done in Yoga and Pilates but can be done without running initially, like on the bike, in the pool or on a cross trainer at the gym. This will reduce the stress you put on your gluteus medeus tendon and also help you to lose weight at the same time. You don't have to start off cycling/swimming continuously for hours at a time, just try 5mins with a 1 min rest to start and repeat that 3-4 times, then reduce the rest and increase the time you are exercising for until you can do 30min. Once you reach 30min exercising at an intensity were you feel breathless but can still talk, then you can increase the time you exercise to 35 min and so on. To get back running you need to think of the same type of training but maybe only running for 2 min and rest for 1 min... the progression needs to be much slower to make sure you don't aggravate the tendon. Cardio/running is only one way to help to lose weight, you need to increase your metabolism by doing some resistance training as well, but thats a whole other topic.If you haven't got a physio as yet i'd definitely recommend you looking into finding one that can teach you good hip and pelvic control and help you graduate your return to exercise programme. I'm sure you can do the 4km, its just about taking it slow and getting good advice. I hope that helps and good luckGeoff (From the SSOP team)* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi Everyone,There's lots of great information in this thread, but if you have any new questions, could you please post in this years thread here: http://bit.ly/KVzAtx
Hi Brad,Hoping you can help. I've developed pain in my heel of one foot. The pain is at the back of my foot on the heel bone. The bone feels bruised and hurts quite a lot when walking or standing.Thanks,Sarah
Hi There,I am 48 - lost about 35kg last year (slowly put back on about 10 though), and have been enjoying alot of running. Ran a 10k+ event last year with my son, and we plan to do it again (and aiming for the Half-Marathon) this year! As part of our training, we did a very short run - 1km in one direction, and 1km back. It was during this very easy run that something happened to my leg. I can still run ok, but find it hard to initially walk! To give a better illustration, we recently went to Luna Park for the slides at Coney Island. Grabbing my mat, I felt proud how fast and easy it was to run up to the top of those stairs to ride down the slide. But... when I got to the bottom of the slide, it was painful to get up! The pain seems to come from behind the knee, the lower leg muscle. I also feel a bit of discomfort overnight on the right side of my left knee (same leg) at night time. Is this common? What do you think I can do - I dont want to pull out of my races; but am wondering if I just use a band around my leg, get new runners, or do I need an anti-inflammatory or something?
Hi Martin,Well done on your running progress and fitness gains. I am sorry to hear of your recent injury.This is a little difficult to advise without further information and assessment. The region you are referring to - "the lower leg muscle, behind the knee, on the inside", if muscular in nature, could possibly relate to the medial head of gastrocnemius, popliteus or plantaris tendons; any of which may have suffered a strain or overuse. Potentially you mean a little higher in which case it may be one of the medial hamstring tendons/muscles. If it is a muscle/tendon strain it would be important to properly rehabilitate the injured area with a targeted rehabilitation programme, best guided by a physiotherapist.However, pain in this region may also be related to the joints of the knee (tibiofemoral or patellofemoral), or may be referred from higher structures including the low back/back of thigh/hip or bottom and nerves of this region.If there is some pain at night it may indicate an inflammatory component or possibly neural irritation.Feel free to send along more information - such as the aggravating and easing movements/activities, exactly where the pain is and what type of pain (sharp, dull, catching etc.), if there are any noises, instability or giving way of the knee, if you have any other injuries (back/hip etc.) and this may assist in understanding your problem. However it is probably best to have your knee checked out by your local physio who will be able to diagnose properly and set you on the right track.All the best!Kerry (Part of the SSOP team)* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi Brad- I am training for the half marathon in Sept and following the marathon guru program. i have hit a piont now where my left glute and hamstring are very tight and painful- if I sit for too long in the car for example it feels sore and numb at the same time. I am alos doing city to surf this weekend and am worried about more damage. I try to stretch and use the foam roller but it is quite tight. I manged 16kms yesterday but had to stop - I was sdupposed to do 22 but did not want to risk it. i have a massage booked tomorrow - but wondering if it could be anything more sinister !!Thanks Elaine
Hi Elaine,Apologies that this post was missed - this year's thread is in a different section (please refer to link "http://bit.ly/KVzAtx" as above).Your left glute and hamstring tightness and soreness could result from several sources. The "numbness" sounds like a neural irritation or impingement which could be related to an impairment at your lumbar spine, pelvis or hip/thigh. Tightness of musculature in this area will affect the tension of the nerve, however other structures including disc, facet joint, pelvic malalignment should be ruled out, as they may require different treatment in order to improve your problem.I would recommend you head to your closest physio to get it checked out and heed their advice as to whether it would be okay to continue running with your issue.All the best!Kerry (Part of the SSOP team)* this is general advice only. For private, tailored and expert consultation, please contact Sydney Sports & Orthopaedic Physiotherapy on 9252 5770, or visit www.ssop.com.au
Hi, I have been training for the running festival for about 4 months now. I have recently been experiencing shin splints, I have been stretching my calf's but it doesn't seem to be having an affect. Is there anything more I can do to ease the pain while I am running?ThanksAlex
HiI have had plantar fasciitis followed by achillles tendonitis on the same foot. I also have osteoarthritis in my opposite knee and think my problems may have been associated with over compensating for the pain in my knee when I walk. Whatever the reason, could you please advise me on what I can do to avoid any further pain in my foot and achilles?ThanksAnne
Hi, I broke my ankle in 2007 and had two operations on it. During the second operation, they removed the cartilage from the ankle. As I am training heavily on it at he moment I am getting a lot of pain, both during my runs and afterwards. Just wondering the best way to treat it after training? Should I apply ice or heat?
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